CLINICAL AND MOLECULAR CORRELATES OF ANTIBIOTIC RESISTANCE IN HOSPITALIZED PATIENTS WITH SYSTEMIC INFECTIONS

Abstract

Antimicrobial resistance poses a significant global health challenge, particularly in hospitalized patients with bloodstream infections, where delays in pathogen identification and susceptibility testing often lead to inappropriate empirical therapy. This study evaluated the clinical and diagnostic impact of rapid molecular diagnostic platforms compared with conventional culture-based methods for the detection of pathogens and antimicrobial resistance in systemic infections.A prospective mixed-methods experimental design was employed, integrating molecular resistance detection, phenotypic susceptibility testing, and antimicrobial stewardship interventions. Diagnostic performance metrics, turnaround times, antimicrobial modification latency, and patient outcomes were quantitatively assessed, while clinician response patterns were qualitatively analyzed.Rapid molecular diagnostics significantly reduced time to pathogen and resistance identification, demonstrating higher sensitivity and stronger concordance with phenotypic susceptibility profiles. Performance comparison tables revealed consistent improvements in diagnostic accuracy, resistance gene coverage, and therapeutic optimization indices. Early availability of molecular results facilitated timely antimicrobial de-escalation or escalation, reducing broad-spectrum antibiotic exposure. Graphical analyses further showed inverse relationships between diagnostic turnaround time and time to appropriate therapy, alongside reduced variability in stewardship-guided interventions. Clinically, these improvements were associated with shorter hospital stays and lower infection-related mortality.Rapid molecular diagnostic systems, when integrated with antimicrobial stewardship programs, provide substantial benefits in the management of bloodstream infections by enabling earlier, targeted therapy and improving clinical outcomes. These findings support the adoption of advanced molecular diagnostics as a key strategy in addressing antimicrobial resistance and advancing precision infectious disease care.